Provider Demographics
NPI:1932612058
Name:SOUTH TEXAS HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:SOUTH TEXAS HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHASITY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:405-761-3419
Mailing Address - Street 1:9614 FRENCH WALK
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4584
Mailing Address - Country:US
Mailing Address - Phone:405-761-3419
Mailing Address - Fax:
Practice Address - Street 1:6391 DE ZAVALA RD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2159
Practice Address - Country:US
Practice Address - Phone:405-761-3419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty